Teddi Mellencamp’s Stage 4 Melanoma
April 15, 2025
TV personality Teddi Jo Mellencamp graciously shared her cancer experience after the star of seventy-two episodes of The Real Housewives of Beverly Hills was initially diagnosed with stage 2 melanoma in October 2022. After spotting a discoloration on her back, the daughter of Hall of Fame singer-songwriter John “Cougar” Mellencamp, publicly announced her condition when the spot removed was biopsied following her checkup.
According to an Instagram post to her million-plus followers, Mellencamp revealed despite her anxiety she felt it was necessary to share her journey online. Not only had the popular reality star avoided skin cancer screenings until her early 40s, she informed followers that in her youth on Hilton Head Island she routinely applied a mixture of baby oil and iodine to her skin in order to speed the tanning process. Like many others during that time period, Mellincamp had mistakenly believed the bronzed skin tone that enhanced her natural beauty was indicative of good health.
"The short-term aesthetics of applying tanning concoctions to make the skin more sensitive to the sun’s rays had hidden repercussions," says Dr. Michael Steppie, Orlando Mohs cancer surgeon and medical director of Associates in Dermatology. "It was the heightened epidemiological research in the mid to late twentieth century that highlighted the link between sun exposure and skin cancer. Fortunately, during the later decades, genetic analyses help to clarify the connection between UV radiation and skin cancer, especially more invasive subtypes like melanoma."
According to the American Cancer Society, millions of skin cancer cases are now diagnosed each year among baby boomers born between 1946 and 1964. Moreover, it most likely was their excess exposure to UV radiation from sunlight or indoor tanning that caused this rise in skin cancer cases. Today, dermatologists feel that many of the skin cancer-related deaths were potentially preventable with proper sun protection, such as wearing protective clothing, sunglasses that block UV rays, avoiding sun exposure during peak hours, applying broad-spectrum sunscreen of at least SPF 30, and avoiding indoor tanning booths.
Hidden dangers of undiagnosed skin cancer...
Metastasis refers to the spread of cancer cells (secondary growths) from where they first formed (primary cancer), which can be a mole, tumor, lesion, or spot. Once cancerous cells break away form the original tumor, they travel through the blood or lymph system to form new metastatic tumors in other parts of the body. Metastatic tumors are the same type of cancer as the primary cancer. Although basal cell carcinoma rarely spreads, both melanoma and squamous cell carcinoma can spread to nearby lymph nodes or distant organs.
Since melanoma subtypes have a distinct risk of metastases, lymph node biopsies help doctors stage the disease. In 2022, the reality star was diagnosed with Stage 2 melanoma, which identifies the tumor to be thicker than normal, but it quickly spread to nearby lymph nodes. After doctors found two more cancerous moles, she was told she might be predisposed to melanomas. In December of that year, she had eleven additional melanomas removed via wide excision skin surgery and shared a graphic image of her cancer surgery scar for World Cancer Day.
The founder of her own lifestyle and fitness company (All In by Teddi) and co-host of a weekly Bravo-centric podcast had three new spots and two additional moles surgically removed over the next couple of years. A big believer in being the best version of yourself that you can be, Mellencamp announced that after weeks of debilitating headaches CT and MRI scans revealed multiple brain tumors in February 2025. Tumors were removed from her brain via a craniotomy but post-surgery scans revealed three additional brain tumors and two on her lungs.
Following her company’s moto of “Go All In” the popular star competed in a Los Angeles equestrian competition with her daughter in March before starting radiation therapy to treat her remaining tumors. Unfortunately, Mellencamp shared a video on Instagram on April 3 announcing her cancer had been classified as Stage 4 after doctors discovered four additional tumors. On April 4, she was pictured ringing the bell to mark the end of her radiation treatment and three upbeat days later connected with a post asking for wig recommendations.
Staging Systems for Skin Cancer
Skin cancer staging helps doctors determine the extent of the cancer and its potential for spreading to other areas of the body from where it is first diagnosed. Disease staging estimates how much cancer there is throughout the body and helps doctors determine the most appropriate treatments, such as surgery, chemotherapy, or radiation. In addition, knowing the stage of the cancer helps doctors determine the risk of recurrence. Here’s some common steps taken:
Biopsy – After the doctor’s physical examination of a skin lesion and nearby lymph nodes, a biopsy is considered to be the crucial first step. This is where a sample of suspicious tissue is removed from a tumor or mole and examined under microscope to confirm whether or not there is a presence of skin cancer cells. This step also determines the type of skin cancer to help doctors plan the most effective treatment options and estimate the outcome or prognosis.
Staging Tests – After the exam and biopsy, staging tests may be prescribed to help determine where occurrences of the skin cancer are located, so the doctor can make an educated guess for the chance of a cure based on the patient’s life expectancy. This includes imaging tests like X-rays, CT scans, MRIs, or PET scans to check other parts of the body for presence of cancer cells. Many times a nearby swollen or tender lymph node is removed and tested via a sentinel lymph node biopsy.
Staging Systems – Depending on the type of cancer, doctors use different systems to assign a 0 to 4, with Stage 0 being the earliest and Stage 4 confirming that the skin cancer has spread to other parts of the body. The TNM System is most often used for staging melanoma and squamous cell carcinoma, but other staging systems like the BWH tumor classification system uses different risk factors to stage squamous cell cancers of the head and neck area. For basal cell skin cancers, staging is usually not necessary as most are cured before they spread.
TNM disease staging system is based on three key pieces of information:
- “T” is the size of the tumor and whether or not the cancer has grown deeper into nearby tissues or structures like a bone.
- “N” is whether or not skin cancer cells have spread to nearby lymph nodes.
- “M” is whether or not the cancer has metastasized or not to distant parts of the body.
NOTE: As a collaborative effort between the American Joint Committee on Cancer and the Union for International Cancer Control, the TNM Staging and other systems help doctor's determine the best treatment options.
Stage 0 is the earliest stage called the carcinoma in situ...
Not everyone diagnosed with skin cancer needs cancer staging, as some lesions are simply treated and cured. However, when a patient’s TNM categories have been determined, the combined information is used to assign an overall stage. The other stages range from one to four with:
Stage 1 melanoma - invasive but not spread to lymph nodes;
Stage 2 melanoma - thicker but not spread to lymph nodes;
Stage 3 melanoma - spread to lymph nodes; and
Stage 4 melanoma - advanced spread to distant parts of the body.
Accurate staging provides crucial information for both patients and doctors when needed. The stage assigned is an educated estimate of both the patient’s life expectancy and the chance of cure. In general, the higher the stage number, the more the skin cancer has spread and the harder it will likely be to treat. One of the most prognostic factor for melanoma is the thickness of the primary tumor (Breslow’s depth) from the granular cell layer in the epidermis to the deepest malignant cell.
Melanoma Prevention and Early Detection
Melanoma rates in the United States have been rising rapidly over the past 30 years and doubled from 1982 to 2011. Although recent trends within the past decade do vary by age, the rate of occurrence dropped to 31.5% from 2011 to 2019. However, according to the latest statistics from the American Academy of Dermatology, invasive melanoma is projected to be the fifth most diagnosed form of skin cancer for both men, with an estimated 60,550 cases, and women, with an estimated 44,410 cases, in the United States this year.
"Early detection of melanoma significantly improves cancer treatment rates," adds Dr. Steppie. "When the potentially deadly skin disease is caught at an early stage, the estimated five-year survival rate for melanoma is 99 percent. Unfortunately, the survival rate can decrease dramatically if the disease mestastasizes to lymph nodes and distant organs of the body." Over 8,400 people are expected to die from melanoma this year. So, Mellencamp’s cancer journey highlights the need for the daily use of proper sun protection and the importance of early detection to prevent spread of the invasive disease.
Teddi Mellencamp’s decision to be transparent with the medical challenges that she has faced is beyond amazing. Without doubt, her willingness to share the consequences of the mistakes she made early in life with her followers makes a statement that can help to save lives. She has done a remarkable job in using all of her platforms to advocate for skin cancer awareness and has become an ambassador for melanoma prevention and early detection by encouraging others to check for suspicious spots and get regular skin checks decades sooner than she did.
_____________________
Early detection of melanoma is the lesson to be learned, as survival rates definitely fall after the disease metastasizes. In fact, once melanoma skin cancer cells reach a patient’s nearby lymph nodes, the five-year survival rates drop to 75 percent and then falls to 35 percent if the deadly disease metastasizes to distant lymph nodes and other organs. Since early detection is so important for the successful treatment of melanoma, call 800-877-7546 or schedule your appointment online at one of our sixteen Central Florida offices in Orlando, Altamonte Springs, Apopka, Celebration, Clermont, Davenport, Dr. Philips, Hunter's Creek, Kissimmee, Mount Dora, Ocoee, Poinciana, Sanford, or St. Cloud.
